Gastrojejunal interposition for esophageal replacement

Area of Science:

• Gastroenterology and Surgical Oncology

Background:

• Esophageal replacement requires careful consideration of graft necrosis, anastomotic complications (leakage, stenosis), and reflux issues.
• Acid-peptic and alkaline reflux are significant concerns following esophageal reconstruction.

Observation:

• A 5-year-old boy with a history of esophageal atresia and stenosis underwent esophageal resection due to duodeno-gastroesophageal reflux.
• Previous thoracic surgeries for esophageal atresia and stenosis were unsuccessful.

Findings:

• Alimentary tract continuity was successfully restored using gastrojejunal interposition.
• This method is recommended when the esophago-gastrostoma is located in the chest, particularly when alkaline reflux is a risk.

Implications:

• Gastrojejunal interposition offers a viable solution for complex esophageal reconstruction cases.
• Careful surgical planning is crucial to mitigate risks associated with esophageal replacement and reflux in pediatric patients.